CMS Releases New WCMSA Reference Guide Version 4.0

User Guide spelled out in wooden blocks

by M. Heberling

On April 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued version 4.0 of their Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) User Guide. CMS added some notable language to the guide, as described below:

Section 11.1.1 – Benefits of Using the WCMSAP & Section 17.5 – Annual Attestation and Record Keeping

CMS indicated that changes to the guide were made to encourage Medicare beneficiaries to make use of their access to the portal for the most efficient method of submitting attestations. In Section 11.1.1 newly added language states:

Beneficiaries may submit attestations online by accessing the portal via their account.

Similarly, in Section 17.5, CMS added the following:

Beneficiaries can submit attestations online by accessing the portal via their account, and professional administrators can submit directly through the WCMSAP—see details in Section 17.6.

Section 10.3 – Rated-Age Information or Life Expectancy

Version 4.0 of the WCMSA Reference Guide now contains a link to the CDC 2021 Life Tables that should be applied to Rated Ages. We previously indicated that this new Life Table would be applied to IMPAXX MSAs and utilized by CMS starting on February 24, 2004.

Thoughts and Takeaways

In a recent blog, we discussed that CMS will be expanding Section 111 reporting to include data for WCMSA arrangements. This includes capturing the MSA amount, details related to how it is being funded, and information on the administration component. Given this upcoming change, we indicated that it may be a good time to consider whether enough is being done to confirm and document the appropriate exhaustion of WCMSAs. With the latest updates to the WCMSA Reference Guide, CMS continues to be focused on how the MSA funds are being spent, including confirmation that beneficiaries have an understanding of their responsibilities post-settlement as well as a clear method for providing information to CMS regarding how their MSA funds were spent.